MurriFlower
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A little girl who has NOT been sexually abused has labia that are still fused shut. To view the hymen would require manual separation of the labia which would be painful for a child.
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Labial_adhesions
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Summary
Labial adhesions, or fused labia, means that the inner lips of the external female genitals (labia minora) have stuck together. This common condition affects up to two per cent of girls aged three months to six years. In most cases, labial adhesions resolve by themselves during the onset of puberty without the need for medical treatment. Treatment may include oestrogen cream and surgery to separate the labia.
Symptoms
The symptoms of labial adhesions can include:
* The inner lips are joined together.
* The condition is usually painless.
* There may be some vulval soreness in some cases.
* Dribbling urine after going to the toilet may be a problem.
* There may be some vulval soreness after urinating in some cases.
* In severe cases, there may be an inability to pass urine.
A range of causes
The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. The range of possible irritants include:
* Faeces
* Urine
* Strongly perfumed soaps
* Bubble baths
* Inflammatory conditions such as vulvitis
* Atopic dermatitis
* Pinworms
* Labial injuries
* Sexual abuse.
The labia fuse together
The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. Usually, the labia start to fuse at the bottom end (posterior fourchette), closest to the anus, and work up towards the clitoris.
Labial adhesions are more common during the nappy years. Poor hygiene is thought to be a common cause in older girls. Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.
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